Torkard Hill Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Torkard Hill Medical Centre on 2 December 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Most risks to patients were assessed and well managed such as health and safety, safeguarding and infection control. However, risks had not been assessed in relation to non clinical staff undertaking chaperone duties. These staff had not been risk assessed or received disclosure barring service checks. This was however, rectified immediately following our inspection for all non clinical staff providing chaperone duties.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. A programme of continuous clinical audit was in place which drove quality improvement. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. The practice was rated highly by patients in patient survey data and feedback we obtained from patients supported this.
• Information about services and how to complain was available and easy to understand. The practice ensured a robust approach was adopted to address all complaints received.
• Patients said however that they found it difficult to make an appointment with a named GP and get through to the surgery by phone to make an appointment. The practice had reviewed patient accessibility and had invested additional resource into GP led telephone triage. The practice was planning to expand its building to accommodate an increasing patient list.
• The practice had good facilities, including a reception waiting area which had been recently redesigned for patient comfort and convenience and it was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

We saw one area of outstanding practice:

The practice had proactively sought to screen all of its care homes patients considered as suitable for dementia screening. This identified 55 to date who were suitable and 62% of these were found to have a diagnosis of dementia. Those identified had their prescription reviewed to ensure optimisation and compatibility with the patients’ condition, care plans developed and referral where required to the dementia outreach team. The practice had also sought to identify any carers of these patients, even if they were not patients at the practice to offer them support. Whilst it was noted that work was ongoing, all identified carers have been offered an annual health check, membership of a carers group and asked to join the patient participation group. (PPG) Those identified as carers were also asked to engage in a collaborative dementia research project which the practice hoped will further increase their understanding of best practice for supporting patients and carers living with dementia.

There are areas where the provider must improve;

The provider must ensure the arrangements in place for identifying, assessing and mitigating risk are effective in relation to non clinical staff undertaking chaperone duties. This includes assessment of whether disclosure barring service checks are required. It has however been noted that the provider took immediate action to address the risk.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice